To evaluate the association between Fe deficiency anaemia (IDA) and complementary feeding in children under 2 years old assisted by the Conditional Cash Transfer programme, Bolsa Família (BFP).

Cross-sectional study. Data were obtained through a standardised form, questionnaire to assess the eating habits of children under 2 years of age, capillary Hb (HemoCue®) and the Brazilian Household Food Insecurity Measurement Scale. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels.

Six municipalities from the State of Alagoas, Brazil.

Children aged 6–24 months assisted by BFP.

A total of 1604 children were evaluated, among whom 58·1 % had anaemia. A higher number of food groups consumed (prevalence ratio (PR) = 0·97; 95 % CI 0·95, 0·99; P = 0·009), the consumption of dairy (PR = 0·86; 95 % CI 0·79, 0·84; P = 0·001) and meat (PR = 0·90; 95 % CI 0·83, 0·99; P = 0·030) in addition to bottle feeding (PR = 0·88; 95 % CI 0·82, 0·96; P = 0·004) were associated with a lower prevalence of IDA.

IDA is still a serious public health problem in children under 2 years old assisted by BFP in Alagoas. We highlight the importance of promoting complementary feeding based on a diversified dietary intake, as well strengthening prophylactic supplementation programmes to increase children’s adherence in conjunction with the implementation of food and nutrition education to help reduce the prevalence of this condition.

To evaluate the association between the consumption of ultra-processed foods (UPF) and the practice of breast-feeding in children under 2 years of age assisted by the conditional cash transfer programme, Bolsa Família Programme (PBF).

A cross-sectional study. The consumption of UPF and the practice of breast-feeding were assessed using a structured 24-h recall. Associations were calculated using hierarchical Poisson regression, adjusted at the last level by socio-economic, demographic and environmental variables from previous hierarchical levels.

Six counties from the state of Alagoas, Brazil.

Children aged 6−24 months, assisted by PBF.

A total of 1604 children were evaluated, 11·7% of whom were overweight, and most had consumed UPF (90·6%) in the last 24 h. The most consumed UPF were biscuits, chocolate milk and baby food with 74·8, 66·8 and 24·9%, respectively. Through multivariable analysis, an association was found between lower consumption of UPF in the continuation of breast-feeding until the second year of life (prevalence ratio (PR) 0·91, 95 % CI 0·86, 0·96) and in the first year of life (PR 0·93, 95 % CI 0·88, 0·99).

It was found that the studied population had a high consumption of UPF, which harmed continued breast-feeding. We highlight the importance of strengthening public policies aimed at the promotion, protection and support of breast-feeding and healthy complementary feeding aimed at populations that have difficulties in physical and economic access to a healthy and adequate diet.

A significant proportion of elderly patients admitted to the medical wards have psychiatric comorbidities, such as delirium, depression or dementia. Frequently they develop cognitive changes during the hospitalization which constitute an important motive of referral to psychiatric services. The MMSE is considered a useful way to document cognitive impairments.

The aim of this study is to evaluate the capacity of MMSE to detect cognitive changes in elderly subjects referenced for liaison psychiatry service.

Observational study developed between October of 2011 and July of 2013. Included subjects with 65 years and older hospitalized in Internal Medicine service referenced for old age liaison service. Each patient was analyzed according to: social demographic characteristics, medical and psychiatric comorbidities and clinical severity. MMSE was applied to all patients.

Of all 143 patients observed about 30% were referenced because of cognitive changes. Of the total, 46% didn’t collaborate in MMSE. These patients were diagnosed with delirium (52%), delirium superimposed with dementia (17%), depression (12%), adjustment disorder (6%), dementia (3%), psychosis (3%) and others (7%). The main reasons of uncooperativeness, with exception of disturb of conscience and/or attention deficits were: visual difficulties (50%), motor difficulties, physical restraints, distracting environment, duration and extension of the exam and anxiety and/or depressive symptoms.

The cognitive assessment of elderly subjects with MMSE in medical settings is compromised by many aspects, including the inherent characteristics of the clinical environment. A more useful, practical and applicable test is needed to evaluate this specific population.

Previous epidemiological studies clearly demonstrated gender differences in the patterns of mental illness. as a matter of fact, female suffer more from depressive and anxiety disorders, while male suffer more from addictive behaviour and psychotic disorders.

The present study was elaborated by the Psychiatric Department Quality Commission of the Coimbra University Hospital in order to identify gender differences in socio-demographic and clinical characteristics of patients that were hospitalized from January to June 2011.

We analyzed 417 clinical files and gathered socio-demographic information (gender, age, marital status and job) and clinical information (diagnosis and hospitalization's length).

Statistical analysis was performed with SPSS program, using the chi-square's and Mann-Whitney's tests.

53% of the inpatients were women.

It was also observed that women were older (p = 0.021), more frequently married and widowed (p < 0.001), were less associated with compulsory admission (p < 0.001), had shorter hospitalizations (p = 0.024) and were more often diagnosed with adjustment reaction and bipolar disorder (p < 0.001), while men were younger (p < 0.001), more frequently single (p < 0.001), more frequently unemployed (p < 0.001), were more subject to compulsory admission (p < 0.001) and were more often diagnosed with addictive disorders and schizophrenia.

These results are consistent with the existing literature and enable us to organize the services’conditions according to the needs of our psychiatric inpatient population.

Previous research suggests that various types of childhood maltreatment frequently co-occur and confer risk for multiple psychiatric diagnoses. This may mean that childhood maltreatment increases vulnerability to a great number of specific psychiatric disorders through diverse and specific mechanisms or that childhood maltreatment engenders a generalised liability to dimensions of psychopathology. Gender differences have been suggested to play a role in this associations.

To compare demographic and clinical characteristics of young adults with history of childhood maltreatment admitted to a psychiatric unit, according to gender.

To delineate the impact of gender on the psychopathology of young adults submitted to childhood maltreatment.

Retrospective data of patients aged 15 and 23 and admitted to a psychiatric outpatient unit, from December 2010 and December 2013, were reviewed. The demographic and clinical characteristics of the two genders were compared.

Childhood maltreatment was associated with elevated odds of mood, anxiety and drug disorders in both genders, but gender differences emerged with physical abuse associated only with externalising liability in men, and only with internalising liability in women. There were no gender differences in age of onset.

Childhood maltreatment have gender-specific consequences for the expression of psychopathology, suggesting gender-specific aetiological pathways between maltreatment and psychopathology.

Hashimoto's encephalopathy is a rare neurological disorder of unknown cause associated with thyroid autoimmunity. The disease may present in two types - a sudden vasculitic type or a progressive subacute type associated to cognitive impairment and psychiatric symptoms.

Report a case of a patient with Hashimoto's encephalopathy presenting with neuropsychiatric symptoms.

Highlight the diagnostic difficulties of medical disorder presenting with clinical features overlapping psychiatric syndromes.

Review of the scientific literature and patient's clinical notes.

A 61-year old female without previous psychiatric history was referred to psychiatry consultation for depressive symptomatology in the last year. She was prescribed with antidepressants with some initial overall improvement, but gradually developed, during the next nine months, cognitive impairment with loss of skills to be independent and increasing tremor of the extremities. Neurological evaluation was requested which revealed frontal functions impairment. Blood workup only found increased titers of anti-thyroid antibody. EEG showed mild bitemporal slowing, brain MRI was normal and brain SPECT scan revealed fronto-temporo-parietal hypoperfusion. Hashimoto encephalopathy was presumed and corticoids were started with significant improvement of neuropsycological symptoms and tremor. After one year she remains assymptomatic.

Hashimoto's encephalopathy is a diagnosis of exclusion and clinical suspicion is essential for its identification. This unusual disorder is often unrecognized for a long time because of the multiple and protracted neurocognitive manifestations and normal findings in several different examinations.

This case also highlights the importance for close collaboration between psychiatrists and neurologists.

Dysexecutive syndrome (DS) is characterized by impairments in executive function and emotional and behavioural disturbances. Available pharmacological interventions for cognitive enhancement, have limited efficacy in improving the symptoms while metylphenidate is known to be effective in Attention Deficit/Hiperactivity Disorder, a condition characterized, as in DS, by prefrontal cortico-subcortical dysfunction.

To report a case of successfull management of severe DS with methylphenidate.

Evaluate the effectiveness of methylphenidate on DS.

A 49-years-old male patient with severe vascular DS, was started on methylphenidate 10 mg daily (increased to 36 mg id).Patient was evaluated with Mini-Mental State (MMS), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) at T0 (before intervention), T1 (after 48 h), T2 (after 6 months) and T3 (after 18 months). Single photon emission computed tomography (SPECT) was undertaken at T0 and T3.

A rapid and sustained improvement was observed, with a 23% improvement in MMS), decrease of 83% in CGI and a 24.5% reduction in total BPRS, at T1 with beneficial effects persisting at T3. Brain SPECT at T3 revealed an improvement of perfusion deficits documented at T0.

Methylphenidate rapidly improved the symptoms of DS, and the effect persisted over 18 months with an associated improvement in brain perfusion.

Methylphenidate can thus be a promising therapeutic choice in cases of DS.

Brief Psychiatric Rating Scale (BPRS) is a widely used outcome measure to assess 24 different psychiatric symptoms. For several reasons it is important to study psychiatric subsyndromes instead of investigating separate symptoms because these subsyndromes may point to a common neurobiological pathogenesis or may have similar treatment.

The focus of the present study was to determine the factor structure of the BPRS for psychiatric inpatients with different diagnostics. The aim of this study was to detect subscales of the 24-item BPRS that could bring some relevant information to sustain the daily practice.

Factor analysis of symptom ratings recorded on the BPRS for a sample of 139 inpatients, during the first week of hospitalization at the department of Psychiatry of HUC between April 2010 and September 2011. Principal component analysis (with Varimax rotation) was used for factor analysis.

The results of the exploratory factor analyses obtained eight factors, which explained 73,225% of the variance in the data. The first factor represents 19.511% of the total variance, and the other seven factors represents, respectively, 13.069%, 10.938%, 7.995%, 6,491%, 5,524%, 5,094% and 4,603%.

Results showed the presence of eight subscales. This study provides additional evidence of the existence of subsyndromes in psychiatric disorders which can give insight into possible relationships between individual symptoms and their underlying pathogenesis.

Most mental disorders begin during adolescence and early adulthood (18–24-years-old), highlighting the importance of understanding the onset and progression of mental disorders among youths. Although progress has been made, namely by creating youth mental health transition services, gaps continue to exist. Locally, our recently constituted young adults unit aimed to minimize discontinuities in care.

To characterize a population of young adult psychiatric outpatients, regarding socio-demographic and clinic variables.

Socio-demographic and clinic characterization of young adult psychiatric outpatients observed during 1st January 2015–30th July 2016.

Two hundred and fifty-five outpatients were observed: 64.3% females and 35.7% males, average age 20.56-years-old (median 20). Most lived in urban areas (59.4%), with their parents (27.8%), were students (80.4%), attending secondary school (36.1%). A total of, 27.5% were referenced by an emergency department, and adjustment disorders (ICD-10 F43.2) were the most frequent diagnosis (21.6%). Regarding suicidal behaviours and self-harm, 9.8% did self-cutting. A vast majority did not have previous psychiatric hospitalizations–only 5.9% outpatients had at least one. In total, 39.8% were medicated with antidepressants (1/3 of which in association with other drugs), and about 38.8% received cognitive-behavioural interventions. About 2/3 of patients (66.3%) remained in care and only about 1/6 (15.7%) were discharged.

Our typical youth psychiatric outpatient was of female gender, student, living with its parents. Adjustment disorders were the most frequent diagnosis, and antidepressants were the main psychopharmacologic option, often combined with other psychotropic drugs. In the future, psychotherapy interventions should be more widely available, namely group psychotherapy.

The authors have not supplied their declaration of competing interest.

Psychopathology rating scales have been widely used. Studies evaluating the congruence between self and observer-reported ratings show inconsistent results.

Determine whether there was consistency between psychopathology as assessed by patients and clinicians’ assessment in outpatients observed in the Young Adult Unit of our Psychiatry Department (Coimbra Hospital and University Centre-Portugal).

Socio-demographic characterization was undertaken with young adult outpatients observed during nineteen months (1st January 2015–31st July 2016). Brief Symptom Inventory–53 items (BSI-53) and Brief Psychiatric Rating Scale (BPRS) were applied at the first clinical evaluation. Spearman correlation coefficient between General Severity Index (GSI) of BSI-53 and BPRS total score was calculated.

During the mentioned interval 255 outpatients were observed: 64.3% females and 35.7% males; aged between 17 and 39 years old (average: 20.56; median: 20). Fifty percent were diagnosed with neurotic, stress-related and somatoform disorders (ICD-10 F40-48) and 14.1% with mood disorders (ICD-10 F30-39). BPRS and BSI-53 rating scales were administered to 55 patients: 72.5% females and 27.5% males; average age 21.2. A statistical significant correlation was found between BPRS total and GSI score.

Several factors can determine the accuracy of psychopathology self-assessment, including diagnosis and severity of illness. In fact, studies show strong correlation between self and observer assessment of depressive and anxious psychopathology, but no correlation in psychotic psychopathological dimensions. Therefore, the correlation found in this population can be explained by the fact that the majority of patients were diagnosed with neurotic, stress-related and somatoform and mood disorders.

The authors have not supplied their declaration of competing interest.

There is an increased risk to develop mental disorder during adolescence and early adulthood. Given this vulnerability, and in order to facilitate the transition from child and adolescent to adult mental health services, specific services for this age group have been developed in the last years, focusing on accessibility and early referral of young mental patients. Our Psychiatry Department (Coimbra Hospital and University Centre, Portugal) created a specific unit for young adults in order to provide better care, in accordance with the specificities of this subpopulation. The team consists of psychiatrists, psychiatry residents, nurses and a clinical psychologist. Referred patients are under 20 years old, presenting clinically relevant psychopathology or behavior disturbances.

We aimed to characterize help-seeking outpatients regarding socio-demographic variables and its relation to depressive and anxiety symptoms.

Socio-demographic characterization was undertaken with young adult psychiatric outpatients observed during eleven months (1st January to 30th November 2015). Multivariate analyses were performed to identify a relationship among socio-demographic and psychopathology variables (assessed with the Portuguese version of Brief Symptom Inventory–53 itens).

One hundred and sixty-two outpatients were observed: 97 females (59,9%) and 65 males (40,1%), ages between 17 and 31 years old (average: 19,9; median: 20). We found a positive correlation between depressive and anxiety symptoms and the education level. A negative correlation was found between depressive and anxiety symptoms and male gender and presence of mental illness in the family.

The authors have not supplied their declaration of competing interest.

Portuguese young adults (15–34 years old) were more frequent engaged in substance abuse (1.2%) than the general population, according to the Portuguese substance use annual report (2014). Alcohol was the most frequent substance use on youth adults. Cannabis was the most frequent illicit substance used (23.9% of users were considered dependent), with higher prevalence than previously reported. LSD (0.4%) use was also higher among young adults than in previous studies. Cocaine (0.4%), heroine/opiates (0.4%), ecstasy (0.3%), and hallucinogenic mushrooms (1.1%) had their consumption lowered among young adults.

To characterize a population of young adult psychiatric outpatients, regarding substance use and associated risk.

Socio-demographic characterization of our young adult unit outpatient users between 1st January 2015–31st July 2016. Substance use was assessed with the Portuguese version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).

A total of 255 outpatients were observed during the timeframe; 58 outpatients were assessed with ASSIST: 44 females (75.9%) and 14 males (24.1%), aged between 16–33 years old (average: 20.95; median: 19.50). For tobacco, 3.5% had high risk, 37.9% moderate risk and 58.6% low risk; 22.4% had moderate risk of alcohol, 13.8% moderate risk of cannabis, and 20.7% moderate risk of tranquilizers. For others substances (cocaine, stimulants, inhalants, hallucinogens, and opiates) the risk was low.

In our sample, alcohol and cannabis use had the highest risk, as reported in the National Annual Report; however, we observed a moderate risk for tranquilizers use. In future care planning, youth mental health should address tobacco and alcohol abstinence, and preventive measures regarding anxiolytics should be undertaken, such as banning sale without medical prescription.

The authors have not supplied their declaration of competing interest.